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NPI Code Detail

MEDICARE: FLORIDA CLINICAL PRACTICE ASSOCIATION INC

MEDICARE: FLORIDA CLINICAL PRACTICE ASSOCIATION INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant
2363L00000XNurse Practitioner
3207V00000XObstetrics & Gynecology Physician
4208000000XPediatrics Physician
5207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144380718
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA CLINICAL PRACTICE ASSOCIATION INC
Provider Business Mailing Address
First Line : PO BOX 13833
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19101-3833
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1707 N MAIN ST
Second Line :
City : GAINESVILLE
State : FL
Zip : 32609-3650
Country : US
Telephone Number : 352-265-7922
Fax Number :
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT
Name : JEREMY SIBISKI
Credential :
Telephone Number : 352-265-8017
Provider Enumeration Date : 12/12/2006
Last Update Date : 11/24/2020

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Directions to “FLORIDA CLINICAL PRACTICE ASSOCIATION INC ” Practice Location

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